As I walked into Sara’s room I was halted by the vision of large pink organdy butterflies dancing over Sara’s bed. Long pale pink ribbons trailed down about six inches moving ever so delicately in the slight breeze coming through the open window. Against the wall two three foot wide hot pink organdy butterflies with sequined tipped wings lay flat, ready to be witnessed and loved. Behind Sara’s bed hung two plaks. One read Laugh and the other, Dream. I paused as tears rolled down my cheeks. Sara lay looking into the butterflies overhead touching the ribbons with awesome joy. She then looked at me and broke into laughter.
How did I cultivate the opportunity to share in this depth of a daughter’s love and her devotion in keeping the end of her mother’s life filled with beauty? How did I ever create a professional life that looks like this. It is truly a blessing.
The blessing, however doesn’t come without challenges. The skill base required to go into private homes and health care facilities to provide massage for dying persons and communicate with the families and health care professionals is multifaceted. It requires specialized in person training.
Currently I have nine clients. All clients are in the final stages of their lives. Five clients are in hospice care. Two clients are in private homes and seven clients are in health care facilities. Three of my clients can speak, and two of the three are able to carry on a conversation. Six of my clients are non verbal.
*I am challenged to assess the outcomes of my sessions kinesthetically, by listening to the client’s body, observing the body’s animation and by being quiet and centered enough to hear my intuition.
*I am also challenged by having clients who can not move. I have to be creative and find positions that allow me to touch my client without hurting myself. The challenge of attending to my physical body onsite requires a deep level of commitment to honor my own comfort. Having compassion for myself has been a difficult kindness to learn.
*Adapting massage techniques to work in varied positions, with a client who can not move requires constant modification, patience and letting go of concepts of what massage is supposed to look like.
The session with one of my clients includes her neck, and the arm ,shoulder, leg and foot on my side of the bed. Her bed is against the wall and her body is rigid. The opposite leg can not be moved over without great stress. It frightens her. My challenge is to let the other side of the body go. I have had to learn that the greatest outcomes from touch are deeper than the sum of body parts I can reach.
*Gathering information on my clients as a private practitioner can be challenging because health care facilities are bound by confidentiality guidelines. I have to make sure I take the time to gather all the information I need from my contracting agent before I arrive onsite. That might be a family member, care organization, conservator, a nurse, or all four contacts. Each contact will have a different level of information. Gathering sufficient information takes time, patience and skill.
*Working as a private practitioner rather than for any specific organization allows me to set my preferred fees, adjust session length and gives me scheduling flexibility. My greatest challenge is reporting to my contracting agents who serve in a wide range of roles. Dialogues are different with family members than with nurses and conservators.
I send written reports once a month to my contractors which include touch techniques utilized, the clients receptivity, outcomes , including physical and emotional response and an assessment of any props or care strategies that might support the comfort of my client. Family members will often want me to call after sessions to report verbally as well, especially at the beginning of the relationship and at the end. I have to keep in mind that the family is grieving. Time, compassion and skill are required.
Family members will often want to be involved in sessions. Guiding a son or a daughter in gently touching or holding their mother at the end of her life are moments that I treasure. The challenge is being comfortable with this depth of intimacy. The questions I ask myself are,“Am I soft enough? Am I vulnerable enough? Am I honest enough?”
Blessings and Gratitude,
Irene Smith www.everflowing.org
Comments
You are welcome Irene...don't even remember what I wrote except that I am grateful for your contributions here. Blessings.
Greg I wanted to thank you for your kind words and for introducing this post. I did something wrong and deleted your comment. oops
Yes Patricia. When all other avenues of communication are fading, touch, because it is our original language, can provide hope and ease the dispair of loved ones because it allows them to stay directly connected. It bridges the gap of silence in the room that sometimes feels so loud.
One of my favorite quotes from a daughter of a client is," Skilled touch has taught me that holding my mother's hand or rubbing her feet is enough. Although my mother no longer knows me as her daughter she knows on some level that I am a welcomed presence."
Thank you very much for your comment Patricia.
Just beautiful! Sadly it seems that touch at the end of a life, is lessened by others fears, concerns about the dying process. But it seems you are able to guide a family on the way that this particular connection will serve both the patient and the family so very well. What a gift you offer!